1629025101 NPI number — PLANNED PARENTHOOD OF THE HEARTLAND, INC

Table of content: (NPI 1629025101)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629025101 NPI number — PLANNED PARENTHOOD OF THE HEARTLAND, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF THE HEARTLAND, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FORMERLY: PLANNED PARENTHOOD OF GREATER IOWA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629025101
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1171 7TH ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50314-2505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-280-7004
Provider Business Mailing Address Fax Number:
515-280-9525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 E. ARMY POST RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50315-5939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-953-7560
Provider Business Practice Location Address Fax Number:
515-953-7549
Provider Enumeration Date:
05/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JUNE
Authorized Official First Name:
JILL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
515-235-0401

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  03119 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: 24217 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 220459 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4029561 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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